POSTPARTUM 1

Question 1

Six week period after childbirth

4th trimester of pregnancy

Answer 1

Postpartum

Question 2

Latin word
Puer “Child”
Parere “To bring forth”

Answer 2

Puerperium

Question 3

The Transition

Childless or Parents of one

New role as parents (Parenthood)

Answer 3

Psychological Changes

Question 4

~Dependent
~Birth Experience
~Time of reflection
~Passive

Answer 4

Taking in phase of the Purperium

Question 5

Initiates action greater independence ideal for teaching

Answer 5

Taking hold phase of the Purperium

Question 6

Giving up:

• old role
• previous lifestyle
• ideal birth experience

~ Readjustment of
relationships

Answer 6

Letting go phase of the purperium

Question 7

MATERNAL CONCERNS AND FEELINGS IN THE POSTPARTAL PERIOD:

1.) Feeling abandoned and less important after giving birth

2.) Disappointment in the baby in terms of the baby’s sex, size or look may be experienced by parents or partners

Answer 7

1.) Abandonment

2.) Disappointment

Question 8

~ Conflicting feelings of joy and emotion letdown during first few weeks after birth

~ Evidenced by tearfulness, feelings of inadequacy, mood lability, anorexia and sleep disturbance

Answer 8

Postpartum blues or Baby blues

Question 9

BABY BLUES:

Fluctuating hormones
• response to dependence & low self-esteem exhaustion
• being away from home
• physical discomfort
• tension engendered by assuming a new role
• Not having support from the partner

Answer 9

Mood Elation Depression

Question 10

~ Occurs during pregnancy

~ Women look to role models (especially her mother)

~ How to mother

Answer 10

Anticipatory Stage

Question 11

~ Begins when the child born
~ Woman is still influenced by the guidance of others
~ Trues to act as she believes others expect her to act

Answer 11

Formal Stage

Question 12

~ Begins when the mother begins to make her own choices about mothering

~ Begins to develop her own style of mothering and finds ways of functioning that work well for her

Answer 12

Informal Stage

Question 13

~ Finale stage of maternal role attainment
~ When the women reaches this stage
~ She is comfortable with the notion of herself as mother

Answer 13

Personal Stage

Question 14

Challenges of the postportal women

Answer 14

Finding time for themselves
Fatigue
Feelings of incompetence
Feeling of responsibility
Infant’s behavior

Question 15

Influencing Factors
(Regarding success in attaining the maternal role)

Answer 15

~Social support
~Age
~Personality traits
~Marital relationships
~Anxiety / Depression
~Previous child care skills
~Temperament of infant
~Socio-economic status

Question 16

UTERUS:
Reduction in size and return of uterus to a non pregnant state

Answer 16

INVOLUTION

Question 17

2 main processes involved in the reproductive system postpartum

Answer 17

1.) Sealing of placenta site

2.) Reduction of organ to approximate pregestational

Question 18

Weight of Uterus:

Immediately after birth -
At the end of the first week -
Complete involution (6 weeks) -

Answer 18

1.) 1000g
2.) 500g
3.) 50g (similar to pre pregnant state)

Question 19

FUNDAL HEIGHT:
1 hour later, fundus on level of 1.)_________, where it remains for approximately the next 2.) ___________.

Decreases one 3.)_____________ per day

Answer 19

1.) Umbilicus

2.) 24 hours

3.) Finger Breadth

Question 20

UTERINE ATONY:
1st Hour

Answer 20

Boggy (soft or flabby)
DANGER!!!!

Question 21

Contraction of the uterus after birth (Intermittent cramping)

~Noticed by most multiparas

~ Happens to those who gave birth to large babies or multiple babies

Answer 21

After Pains

Question 22

Placental Separation

Answer 22

Lochia

Question 23

Color: Red

Duration: 1-3 days

Composition: Blood, fragments of decidua, mucus

Answer 23

Lochia Rubra

Question 24

Color: Pink

Duration: 3-10 days

Composition: Blood mucus and leukocytes

Answer 24

Lochia Serosa

Question 25

Color: White

Duration: 10-14 days

Composition: Largely Mucus

Answer 25

Lochia Alba

Question 26

HEAVY AMOUNT:
Lochia Stain Size and amount

Answer 26

~ Larger than 6 inches in length within 1 hour

~ 50 to 80 ml

Question 27

MODERATE AMOUNT:
Lochia stain and amount

Answer 27

~ Stain < 6 inches in length within 1 hour
~ 25-50ml

Question 28

SMALL AMOUNT:
Lochia stain and amount

Answer 28

~ Stain less than 4 inches in length after 1 hour

~ 10 - 25 ml

Question 29

SCANT AMOUNT:
Lochia stain and amount

Answer 29

~ Stain less than 1 inch in length after 1 hour

~ Only on tissue when the woman wipes

Question 30

Soft and Malleable

Internal and external OS are open

External OS size of a pencil opening

Appears slitlike or stellate (Starshaped)

Answer 30

Post partum cervix

Question 31

~ Soft, with few rugae
~ Diameter greater than normal
~ Hymen PERMANENTLY torn

Answer 31

The vagina after birth

Question 32

The perineum texture and differences

Answer 32

~Edematous
~Tender
~Bruising with ecchymosis

Question 33

HORMONAL SYSTEM:
Pregnancy Hormones ________

HCG and HPL (almost eligible by 24 hours) _____________

Answer 33

1.) Decrease

2.) Decrease

Question 34

HORMONAL SYSTEM:
By week 1, Progestin, Estrogen, Estradiol return back to 1.)__________Levels

2.)__________ (12 days), then begins to rise as
a new 3.)___________ cycle is initiated

Answer 34

1.) Pre Pregnancy

2.) FSH

3.) Menstrual

Question 35

URINARY SYSTEM:
UO 1.)________ml/day (Diaphoresis and Diuresis)

Transient loss of tone and Edema (Bladder) = 2.)__________

Hydronephrosis = 3.)___________

Answer 35

1.) 3000

2.) Lowered sense to void

3.) Increased possibility of urinary stasis and UTI

Question 36

CIRCULATORY SYSTEM:
Blood volume 1.)____________

Amount of blood loss VSD 2.) __________

Amount of blood loss CS 3.)____________

Answer 36

1.) Decreases

2.) 300-500 ml

3.) 500-1000ml

Question 37

INTEGUMENTARY SYSTEM:

~ Stretch marks Still appear 1.)__________; will fade in time

~ Rectus muscle tone is not 2.)___________

Answer 37

1.) reddened

2.) Regained

Question 38

RETROGRESSIVE CHANGES OF THE PUERPERIUM

Answer 38

~ Exhaustion = Sleep hunger
~ Weight loss

Question 39

~ Temperature during the first 24 hrs after birth is 1.)________ due to dehydration

~ A oral temperature above 38C febrile may indicate 2.)__________

Answer 39

1.) Increased

2.) Postpartal Infection

Question 40

~If BP is decreased it may indicate 1.)_______

~140 mmHg systolic or 90 mmHg diastolic may indicate 2.)__________

~Occurs on standing due to lack of adequate blood volume to maintain nourishment of brain cells

Answer 40

1.) Bleeding

2.) Postpartal Hypertension

3.) Orthostatic Hypotension

Question 41

PROGRESSIVE CHANGES OF THE PUERPERIUM

Answer 41

~ LACTATION

~ Estrogen and Progesterone is decreased following delivery of placenta

~ Increased Prolactin and Oxytocin

Question 42

BF = ___or____ months

Not BF = ___ to _____ weeks after birth

Answer 42

BF = 3 or 4 months

Not BF = 6 to 10 weeks after birth

Question 43

If rapid and thready pulse this is a sign of

Answer 43

Hemorrhage